Provider Demographics
NPI:1881611176
Name:ASHKENAZI, ABRAHAM A (MD)
Entity type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:A
Last Name:ASHKENAZI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:599 W STATE ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-2567
Mailing Address - Country:US
Mailing Address - Phone:215-345-0105
Mailing Address - Fax:215-345-0562
Practice Address - Street 1:595 W STATE ST
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-2554
Practice Address - Country:US
Practice Address - Phone:215-345-0105
Practice Address - Fax:215-345-0562
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4229342084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA101166650Medicaid
NJ0053431Medicaid
PA087393Medicare PIN